You've lost your job, your house, and your savings. But, hey, you still have your health, right? Actually, you probably do--and it may even be improving. Researchers have found that, historically, Americans were healthier during the Great Depression and other economic downturns than they were during periods of prosperity. And they say the trend may still hold true today.
For many, the Great Depression conjures up images of wan, rail-thin men waiting in bread lines. At its peak in 1932, unemployment hit 22.9% and U.S. gross domestic product (GDP), a standard measure of economic performance, had shrunk by 14%. Despite these hardships, the average American was healthier during this period than during the economic booms that preceded and followed it, according to social researcher José Tapia Granados and his co-author Ana Diez Roux, both of the University of Michigan, Ann Arbor.
The pair looked at historical life expectancy and mortality data as well as GDP growth and unemployment rates. They focused on the years 1920 through 1940, a period that included the Great Depression (1930 to 1933), a couple of less severe recessions, and several years of strong economic growth. The top-six causes of death at that time were cardiovascular and renal disease, flu and pneumonia, cancer, tuberculosis, motor vehicle accidents, and suicide.
Tapia Granados's team found an inverse association between economic health and population health: Life expectancy fell during economic upturns and increased during recessions. Mortality, meanwhile, tended to rise during economic upturns and fall during recessions. Deaths related to flu and pneumonia, for example, fell from about 150 per 100,000 people in 1929 to roughly 100 per 100,000 people in 1930, the researchers report online today in the Proceedings of the National Academy of Sciences. Suicide was the only cause of death that increased during times of economic turmoil. For life expectancy, the patterns were particularly obvious among nonwhites: Between 1921 and 1926, a period of economic growth, life expectancy declined 8.1 years among nonwhite males and 7.4 years among nonwhite females. During the Great Depression, on the other hand, life expectancy among nonwhites increased by 8 years.
But why? The researchers don't yet have enough data to say. Previous studies have suggested some plausible mechanisms. Economic booms are associated with more smoking and drinking, less sleep, and more work-related stress--all factors that can affect health. In addition, traffic-related deaths and industrial injuries tend to increase during periods of economic growth. Another factor, Tapia Granados says, may involve social support. Recessions tend to bring people together, and people with stronger social support networks tend to be healthier.
One of the reasons that the findings may seem so counterintuitive, says Christopher Ruhm, a health economist at the University of North Carolina, Greensboro, is that it's easy to come up with examples of individuals who have gotten sicker during recessions. "Someone loses their job, they take to the bottle, their health suffers," he says. But these dramatic narratives don't say anything about the overall effect of recessions on the whole population.
Other studies have also suggested that health improves during economic downturns, says Stephen Bezruchka, a physician and public health expert at the University of Washington, Seattle, but this is by far the most all-encompassing study to look at the Great Depression. Taken together, he says, all of the studies suggest that GDP is a flawed measure of societal well-being.